Quick: what’s one of the most common forms of pain? And we are not talking about chronic credit card exhaustion syndrome or who-does-that-manager-think-he-is-itis. Or your family. It’s headaches. We all get them. Some of us are lucky and get them once or twice a year at most; others endure daily, unspeakable agony. Given the season – the holidays! – and the fact that many of us will also have to cope with weather changes and exposure to heating and humidity fluctuations, headaches are very predictable winter house guests. Let’s see if we can’t keep their visits really, really short!
It is estimated that 45 million Americans have headaches severe enough to require professional medical help. Headaches are sometimes related to sore or tender spots in the muscles of the head, neck or shoulders. They also develop when pain-sensitive nerve endings in the scalp, in the lining of the scalp, in the blood vessels surrounding the scalp, or in other nearby areas of the head, send impulses to the brain, which in turn interprets the signals as pain.
Some of the pain is minor and mostly just annoying. Some of the pain, such as that of migraines, is excruciating. Indeed, migraine headaches cause a loss of 157 million workdays per year and take a huge toll on the economy. Some estimates indicate that the direct costs (prescription medications, outpatient expenses, and ED and inpatient care) are $11 billion, while indirect costs (missed days at work and so on) are more than $12 billion. Annually.
Before we take on the world of complementary and alternative care for headache pain, let’s see what headaches are all about. Primary headaches are those that are not symptoms of another medical condition or disorder, and there are three major types:
- Tension-type headaches. This is the number one category, affecting some 38% of American adults each year. Usually affecting both sides of the head, of moderate severity, people often describe a tension headache as feeling like a band tightening around the head. The usual triggers are stress, anxiety, depression and not enough sleep. An episodic tension headache lasts anywhere from 30 minutes to several days. A chronic tension headache generally occurs for more than 15 days a month (not necessarily consecutively) for about three months. Chronic tension headache pain may be more severe than that of an episodic tension headache.
- Trigeminal autonomic cephalalgias (TACs). These are marked by severe pain in and around one eye. Other symptoms include eye redness and tearing, drooping eyelid and runny nose. The most common TAC is called a cluster headache – the pain of which is likened to having a ‘hot, burning poker in the eye’. The attacks, which occur in clusters (hence the name) may go on for weeks, each lasting about 60 to 90 minutes. They often happen at the same time each day or night. Mercifully, cluster headaches are far less common than migraines, affecting about 0.3 percent of the general adult population.
- Migraine headaches. More common in women than men, except in childhood, when they are more likely to affect boys than girls, migraines affect about 12 percent of the US population. The symptoms are well-known: pulsing or throbbing pain on one side of the head, nausea and vomiting, sensitivity to light and sound. The pain ranges from moderate to severe. Chronic migraines are those that occur more than 15 days per month for about three months. The two common types are migraine with aura and migraine without aura. Migraine with aura affects about a third of all migraine sufferers. ‘Aura’ includes visual disturbances and other symptoms: difficulty speaking, confusion, numbness, muscle weakness on one side of the body, a tingling sensation in the hands and face before the onset of the actual headache. ‘Without aura’ migraines are sometimes confused with tension headaches.
- Diet: The culprits include chocolate, garlic, processed meats and fish, aged cheeses, pickled products, caffeine withdrawal and alcohol, most particularly wine.
- Environment: Weather changes, smoke, prolonged loud noise, some odors, exposure to bright light, high altitude.
- Other: Too much sleep or a change in sleeping patterns, fatigue or exhaustion, exertion, irregular motion (amusement park rides, boats), stress, hormonal changes.